Patients' perception and satisfaction on neck and shoulder imbalance in adolescent idiopathic scoliosis

• Main Authors: Lee, Sin Ying, Ch'ng, Pei Ying, Wong, Tat Seng, Ling, Xiu Wen, Chung, Weng Hong, Chiu, Chee Kidd, Chan, Chris Yin Wei, Lean, Mei Li, Kwan, Mun Keong
• Format: Article
• Published: SAGE PUBLICATIONS LTD 2023
• Subjects: RD Surgery
• Online Access: http://eprints.um.edu.my/39641/

Study Design: Cross-sectional. Objectives: To evaluate the perception and satisfaction among adolescent idiopathic scoliosis (AIS) patients on Neck Tilt with Medial Shoulder Imbalance and Lateral Shoulder Imbalance. Methods: Lenke 1 and 2 AIS patients were stratified into 6 groups of preoperative/ postoperative Balanced (B), Lateral Shoulder Imbalance (LSI) (>2 cm), and Neck Tilt with Medial Shoulder Imbalance (NT) (Grade 3). Patients were interviewed using Modified Neck and Shoulder Appearance and SRS-22r questionnaires. T1 tilt, Cervical Axis (CA), Clavicle Angle (Cla-A) and Radiographic Shoulder Height (RSH) were measured. Results: A total of 120 Lenke 1 and 2 AIS patients were recruited. NT patients were aware and unhappy with their abnormal neck with medial shoulder appearances (P < .001). Similarly, LSI patients were aware and unhappy with their abnormal lateral shoulder appearances (P < .001). NT group had larger preoperative/ postoperative T1 tilt (9.2 +/- 5.0 degrees; 9.5 +/- 5.3 degrees) and CA (4.6 +/- 3.1 degrees; 7.0 +/- 2.0 degrees) (P < .01). LSI group had larger preoperative/ postoperative Cla-A (4.8 +/- 2.8 degrees; 4.0 +/- 1.3 degrees) and RSH (20.1 +/- 9.4 mm; 17.0 +/- 6.6 mm) (P < .001). Postoperative B group scored higher in overall SRS-22r scores, self-image and satisfaction domains (4.2 +/- 0.3; 4.0 +/- 0.5; 4.4 +/- 0.5) while preoperative LSI scored the lowest comparatively (3.5 +/- 0.4; 2.4 +/- 0.5; 3.3 +/- 0.5) (P < .001). Conclusion: NT and LSI were major concerns among AIS patients. Both NT and LSI groups were unhappy with their appearances. NT group had larger T1 tilt/ CA whereas LSI group had larger Cla-A/ RSH. Postoperative B group scored higher in overall SRS-22r scores, self-image and satisfaction domains.